Bowel retraining

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Overview

Bowel retraining

Alternative Names:

Exercises for fecal incontinence
Information:

People with fecal incontinence resulting from a variety of causes may benefit from a program of bowel retraining, Kegel exercises, or biofeedback therapy. The bowel program consists of several steps aimed at producing regular bowel movements. Within a few weeks of beginning a bowel program, most people can achieve regular bowel movements.

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PRIOR TO STARTING

Prior to beginning a bowel training program, you should receive a thorough physical examination to identify the cause of the fecal incontinence and treat any correctable disorders, such as a fecal impaction or infectious diarrhea. A history of your bowel habits and lifestyle considerations should serve as a guide for establishing new bowel elimination patterns.

DIET

The diet should be modified to include adequate fiber and fluid intake to promote regular, soft, bulky stools. Add high fiber foods to the diet including whole-wheat grains, fresh vegetables, and beans. Additionally, psyllium-containing products such as Metamucil can be used to add bulk to the stools. Try to drink 2 - 3 liters of fluid a day (unless you have a medical condition requiring you to restrict your fluid intake, such as kidney or heart disease).

BOWEL TRAINING

Establish a set time for daily bowel movements; choose a time that is convenient for you, keeping in mind your daily schedule. It is very important to be consistent in the time of day bowel training is performed. The best time for a bowel movement is 20 - 40 minutes after a meal, since feeding stimulates bowel activity. Some people drink warm prune juice or fruit nectar as a stimulus to bowel movements.

Bowel movements may be stimulated by digital stimulation. Digital stimulation is performed by inserting a lubricated finger into the anus and using a circular motion. Stimulate the lower bowel until the sphincter relaxes. This may take a few minutes. If digital stimulation does not produce a bowel movement within 20 minutes, repeat the procedure.

Digital stimulation should be performed every day to stimulate bowel movement, until a pattern of regular bowel movements is established. Bowel movements may also be stimulated by using a suppository (glycerin or Dulcolax) or a small enema.

After stimulation has been performed, assume a normal posture for bowel movement. If you are able to walk, sit on the toilet or bedside commode. If you are confined to the bed, use a bedpan, in as close to a sitting position as possible, or use a left side lying position if unable to sit. Try to ensure privacy as much as possible. Also, some people find that reading while sitting on the commode helps them relax and aids in bowel evacuation.